High-frequency oscillatory ventilation in pediatric patients with acute respiratory failure

Jaballah, Nejla Ben; Khaldi, Abdelhamid; Mnif, Khaled; Bouziri, Asma; Belhadj, S.; Hamdi, Asma; Kchaou, W.

doi:10.1097/01.pcc.0000227108.38119.2e

Cited by 45 publications

(39 citation statements)

References 34 publications

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“…As regards oxygenation improvement, we found that HFO significantly improved oxygenation after 24 hours of enrollment, a finding that is comparable with results in several pediatric studies 35,[45][46][47] and adult studies 34,36 . Also survivors among HFO group showed significant higher OI decrease percent, PaO 2 /FiO 2 after 24 hours and higher PaO 2 /FiO 2 increase percent.…”

Section: Volume 59 • Number 2 Hfo Versus CMV In Pediatric Ardssupporting

confidence: 77%

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

et al. 2017

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Although the HFO mode appeared to be a safe mode with a significant better oxygenation improvement (after the first 24 hours) and fewer crossover rates, it failed to show differences as regards mortality or LOS when compared to the CMV adopting protective lung strategy. In PARDS, HFO had a superior advantage in improving oxygenation, yet with no significant mortality improvement, as multi-organ dysfunction syndrome (MODS) was the most common cause of death in our study and not refractory hypoxemia which is the main problem in PARDS; highlighting that mortality in PARDS is multi-factorial and may not depend only on how fast oxygenation improves.

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Section: Volume 59 • Number 2 Hfo Versus CMV In Pediatric Ardssupporting

confidence: 77%

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

et al. 2017

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“…To be effective, these modes can require a mean airway pressure 5 cmH 2 O higher than that used with conventional ventilation. This can reduce venous return leading to greater need for fluid resuscitation and vasopressor requirements [612][613][614][615][616].…”

Section: Mechanical Ventilationmentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012

Dellinger¹,

et al. 2013

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“…Animal studies have suggested that early institution of HFOV could limit ventilator-induced lung injury. Nonetheless, it appears that HFOV has largely become a rescue therapy when conventional management fails (38,39). A decade ago, a report of 10 pediatric ICUs showed patients were started on HFOV after a mean of 3.3 days of ventilation at a mean OI of 30 (40).…”

Section: Hfovmentioning

confidence: 99%

The Design of Future Pediatric Mechanical Ventilation Trials for Acute Lung Injury

Khemani

Newth

2010

Am J Respir Crit Care Med

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Pediatric practitioners face unique challenges when attempting to translate or adapt adult-derived evidence regarding ventilation practices for acute lung injury or acute respiratory distress syndrome into pediatric practice. Fortunately or unfortunately, there appears to be selective adoption of adult practices for pediatric mechanical ventilation, many of which pose considerable challenges or uncertainty when translated to pediatrics. These differences, combined with heterogeneous management strategies within pediatric critical care, can complicate clinical practice and make designing robust clinical trials in pediatric acute respiratory failure particularly difficult. These issues surround the lack of explicit ventilator protocols in pediatrics, either computer or paper based; differences in modes of conventional ventilation and perceived marked differences in the approach to high-frequency oscillatory ventilation; challenges with patient recruitment; the shortcomings of the definition of acute lung injury and acute respiratory distress syndrome; the more reliable yet still somewhat unpredictable relationship between lung injury severity and outcome; and the reliance on potentially biased surrogate outcome measures, such as ventilator-free days, for all pediatric trials. The purpose of this review is to highlight these challenges, discuss pertinent work that has begun to address them, and propose potential solutions or future investigations that may help facilitate comprehensive trials on pediatric mechanical ventilation and define clinical practice standards.

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High-frequency oscillatory ventilation in pediatric patients with acute respiratory failure

Abstract: In pediatric patients with acute respiratory failure, failing conventional ventilation, HFOV improves gas exchange in a rapid and sustained fashion. However, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation.

Cited by 45 publications

References 34 publications

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012

The Design of Future Pediatric Mechanical Ventilation Trials for Acute Lung Injury

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